Charity no. 1151152
Birthrights Report and Unaudited Financial Statements
31 March 2024
Birthrights
Reference and administrative details
For the year ended 31 March 2024
Charity number 1151152 Registered office Birthrights Union House 111 New Union Street Coventry CV1 2NT
Trustees The trustees who served during the year and up to the date of this report were as follows:
| Trustees | The trustees who served d were as follows: |
uring the year and up to the da |
|---|---|---|
| Alix-Louise Anderson | Secretary | |
| Tara Arnold | (resigned 16 December 2023) | |
| Rachel Crasnow QC | (resigned 18 July 2023) | |
| Inderjit Cross | (resigned 7 August 2024) | |
| John Davis | Treasurer | |
| Marcia Lord | ||
| Dr Ria May Clarke | ||
| Simon Mehigan | (resigned 16 July 2024) | |
| Sandra Nneoma Igwe | (resigned 28 January 2024) | |
| Elizabeth Prochaska | (resigned 1 November 2023) | |
| Amelia Christie | (appointed 14 August 2024) | |
| Naomi Allen | (appointed 14 August 2024) | |
| Roisin Mulroney | (appointed 14 August 2024) | |
| Krystal Lashley-Scrivener | (appointed 14 August 2024) | |
| Annabel Sowemimo | (appointed 14 August 2024) | |
| Elise Denis-Ramirez | (appointed 14 August 2024) | |
| Co-Chief executives | Shanthi Gunesekera | |
| Janaki Mahadevan | ||
| Patron | Nadine Montgomery | |
| Bankers | The Co-operative Bank | |
| Olympic House | ||
| 6 Olympic Court | ||
| Montford Street | ||
| Salford | ||
| M5 2QP | ||
| Independent | Godfrey Wilson Limited | |
| examiners | Chartered accountants and | statutory auditors |
| 5th Floor Mariner House | ||
| 62 Prince Street | ||
| Bristol | ||
| BS1 4QD |
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Birthrights
Report of the trustees
For the year ended 31 March 2024
1. Introduction from our Interim Chair
Last year, 2023 marked the 10th anniversary of Birthrights, founded by human rights lawyer Elizabeth Prochaska and writer and doula Rebecca Schiller with the understanding that at the heart of the poor experiences and outcomes of maternity care for so many, is a consistent failure to listen to the voices of women and birthing people and a complete disregard for their fundamental human rights.
A decade on and we know that our work is more urgent than ever. The maternity system in the UK is in deep crisis and the experiences and outcomes for many women and birthing people, and their babies, are alarming.
And so in this milestone year, we have taken the time to reflect on how far we have come, but also what more we have to do – building the right team, structure and strategy to make us resilient to the challenging environment we operate in, to drive forward meaningful, systemic changes in maternity care and to continue to demand the rights of women and birthing people are centred during pregnancy and childbirth.
We acknowledge the deep challenges and the essential work that still lies ahead. As we look to the forthcoming year, commencing the recruitment process for a number of new trustees and a new Chair of the Board marks the beginning of a new chapter, alongside the expansion of our face-to-face community advice, developing our training model for maximum impact and building our campaigns to influence real change to maternity care.
We would like to convey our sincere appreciation to the trustees that have stepped down this year following the end of their term of office. First and foremost, Elizabeth Prochaska, founder and former chair – for whom we extend our deep thanks for her vision, determination and all she has created at Birthrights; to Sandra Igwe, Rachel Crasnow and Tara Arnold, for their expertise, support and insights during their time with us.
We extend heartfelt gratitude to everyone who has played a part in our journey so far. Together, we enter our second decade with a strengthened resolve to make birth justice a reality – fighting for the fundamental rights of women and birthing people during pregnancy and birth, now and for the generations ahead.
Indy Cross, Interim Chair
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Birthrights
Report of the trustees
For the year ended 31 March 2024
2. Welcome from our Co-Chief Executives
Birth justice exists when women and birthing people have the right to give birth with whom, where, when and however they choose and when laws, policies and practice supports access to these rights for everyone. These rights exist in international human rights law and UK laws, but access to exercising them is under threat in the UK for everyone and is particularly restricted for the most marginalised and minoritised.
The consistent failure to listen to the voices of women and birthing people and the routine disregard of their human rights is resulting in individual birth trauma and contributing to community and societal trauma and distrust in the healthcare system more widely.
We are hearing of women and birthing people experiencing suspensions of and restrictions to core services without regard to individual need; coercive practice; breaches of consent; lack of respect for bodily autonomy; and referrals to police and social services for refusing interventions. We have also heard from those who feel the only option available to them, in the face of blanket hospital policies and lack of person-centred care, is unassisted birth. This should be a wake-up call to all those involved in decision-making, regulation, management and delivery of maternity services that radical change is urgently required.
A maternity service that understands and protects the rights of women and birthing people during pregnancy and birth is essential to reducing trauma and the provision of safe care. We believe a world where women and birthing people’s bodily autonomy and informed decisions about their care are respected is not only possible, but crucial to a healthy, sustainable and just society.
Birthrights continues to exist to protect the human rights of all women and birthing people in the UK a decade after it was founded, and we move into our next decade with strengthened foundations. Over the past year we undertook an organisational restructure so Birthrights could allocate its limited resources most effectively, including building resilience in our services and bringing in the expertise needed to increase our reach and impact. The development of a new 10-year strategic framework has enabled us to focus and prioritise work towards long-term and systemic change. We have sought to improve the health and infrastructure of our organisation through the roll-out of organisational laptops to all staff, the introduction of customer relationships management (CRM) software, IT migration to Microsoft 365 and an extensive review and development of our internal policies. Whilst making this significant investment in our charity, we have continued to provide critical information, advice and training, and advocate for change.
We are deeply grateful to all those who have provided the vision and leadership for movements for justice and recognise the inspiration we take from their teachings and commit to continue our learning and journey towards anti-oppression. We also want to extend our heartfelt thanks to those who make our work possible - the incredible talent and dedication of our staff team and Associate Trainers who have demonstrated such commitment to championing the rights of women and birthing people throughout a rapidly changing external context, and a period of change for Birthrights. We are thankful to everyone who has supported us in this period of transition in an interim and freelance basis and to those who have generously contributed to Birthrights through poetry, visual media and storytelling. In particular, we wish to thank our founder and outgoing chair Elizabeth Prochaska for her support and faith in us as we undertook our first leadership role in the charity sector.
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Birthrights
Report of the trustees
For the year ended 31 March 2024
We are delighted to welcome many new joiners to the Birthrights team in 2023/24 who are bringing dedicated capacity to our communications, campaigns and fundraising functions for the first time.
Together, in community with women and birthing people and their supporters who continue to fight, often against the odds for justice and equity, we believe a radically different maternity system is possible.
Shanthi Gunesekera and Janaki Mahadevan, co-CEOs
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Birthrights
Report of the trustees
For the year ended 31 March 2024
3. Gratitude
On behalf of the Birthrights’ staff team, our Board and the communities we serve, we are grateful for the continued support from our funders. Thank you to our trust and foundation funders: Esmée Fairbairn Foundation, Thirty Percy, Owl Trust, John Ellerman; Joseph Rowntree Charitable Trust; National Lottery Community Fund and our corporate partners Leigh Day and Irwin Mitchell for believing in and advocating for our work in 2023/24. We would also like to thank all those who have donated so generously to support our work and champion our cause.
And finally, a huge thank you to all Birthrights’ supporters for standing with us to champion the fundamental rights of women and birthing people during pregnancy and birth. Together we can fight for a world where women and birthing people can access safe maternity care that fully respects their right to bodily autonomy and self-agency, free from discrimination, coercion and violence.
4. Structure, governance and management
Birthrights is a charitable incorporated organisation and is registered with the Charity Commission with charity number 1151152.
The method of recruitment and appointment of trustees is set out in its governing document: the constitution. Four trustees stood down between 1 April 2023 and 31 March 2024 – our former Chair and Founder, Elizabeth Prochaska – alongside Rachel Crasnow, Tara Arnold and Sandra Igwe; and one trustee – Simon Mehigan – stepped down after his third term in office in July 2024. Three trustees had their appointments renewed for a second term in line with the constitution – Alix Anderson, Indy Cross and Mars Lord.
The current trustees comprise a finance and business expert, experienced charity leaders, governance specialists, a doula and anti-racism campaigners. Most Trustees have lived experience of maternity care.
The trustees are responsible for making decisions on the management of all the affairs of Birthrights, including deciding on how the funds of the charity are to be spent. The trustees have a duty to identify and review the risks to which the charity is exposed and to ensure appropriate controls are in place to provide reasonable assurance against fraud and error.
The full Board of trustees met five times during 2023/24, including one extraordinary board meeting. The Finance, Audit and Risk Committee also met four times in this period.
5. Objectives and Activities
5.1 About
Birthrights launched in January 2013 when we were established as the UK charity that champions respectful care during pregnancy and childbirth by protecting human rights. We believe that everyone is entitled to respectful maternity care that protects their fundamental rights to dignity, autonomy, privacy and equality. We provide free advice and legal information to women and birthing people, train healthcare professionals and birth workers to deliver rights-respecting care and campaign to change maternity policy and systems. Our research shines a spotlight on those most at risk of human rights violations in pregnancy and birth due to structural disadvantage and discrimination.
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Birthrights
Report of the trustees
For the year ended 31 March 2024
Our vision for 2022-24 was to ensure everyone receives the respect and dignity they deserve in pregnancy and childbirth. Our mission in the same period was to be the authority on human rights in pregnancy and childbirth in the UK and use that influence to improve services and practice throughout the maternity system.
Birthrights does not promote any particular clinical perspectives in maternity care.
5.2 Aims
The aim of Birthrights is to promote the human rights of child-bearing women and people in England and Wales. These rights are set out in the Universal Declaration of Human Rights, the Convention on the Elimination of Discrimination against Women and subsequent United Nations conventions and declarations, and the European Convention for the Protection of Human Rights and Fundamental Freedoms.
5.3 Activities
Birthrights is committed to:
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promoting awareness of the legal rights of child-bearing women and people during and connected to pregnancy, childbirth and the postnatal period (the six weeks subsequent to birth);
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promoting respect for the legal rights of child-bearing women and people among healthcare organisations, medical and other professions and in society at large;
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protecting the human rights of child-bearing women and people through the provision of legal information and advice and obtaining redress for victims of human rights abuse;
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campaigning in relation to human rights and related legal issues relating to child-bearing women and people;
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responding with technical advice to proposed legislation and policy affecting child-bearing women and people;
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providing technical advice to government and others on human rights and other legal and regulatory matters as they affect child-bearing women and people;
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contributing to the understanding and sound administration of human rights law as it affects childbearing women and people, in particular, but not exclusively, through third-party interventions in legal cases;
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promoting the human rights and lawful treatment of child-bearing women and people by commissioning and conducting research;
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providing education and training to, among others, parents and parents-to-be, healthcare professionals and the public on human rights and the law as it affects child-bearing women and people;
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eliminating infringements of human rights of child-bearing women and people; and
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undertaking other charitable activities that the trustees may from time to time determine to promote the human rights and legal status of child-bearing women and people.
When planning our activities for the year, the trustees have considered the Charity Commission’s guidance on public benefit and, in particular, the specific guidance on charities for the promotion of human rights.
The Trust has referred to the terms of the Scheme and the Charity Commission’s general guidance on public benefit when reviewing its aims and objectives and planning future activities. In particular the Trustees consider how proposed activities will contribute to the aims and objectives they have set.
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Birthrights
For the year ended 31 March 2024
Report of the trustees
6. Achievements and Performance 2023/24 Highlights from the Year
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In 2023-2024, we supported more than 151,518 individuals in their journeys for birth justice (measured by unique visitors to our factsheets and just over 750 individuals accessing information and advice through our email service);
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We have begun to offer free community outreach and drop-in advice and information sessions for marginalised and minoritised women and birthing people and their immediate supporters, through community groups. The work commenced in November 2023 and to date we have attended four community group sessions supporting up to 20 women directly each time with information and advice;
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We led 100 training courses for Healthcare Professionals, which was an increase of 85.2% on the previous year, enabling us to reach approximately 2,752 professionals working in maternity settings. This included doctors, midwives, anaesthetists, neonatologists, paramedics, birth workers and maternity investigators;
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98% of attendees across our training sessions stated that their ‘knowledge and understanding of how human rights applies to maternity care’ had improved;
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We provided heavily discounted training for community birth workers and peer supporters in 2023/24 and we delivered three sessions supporting 48 people with the tools to support others in their community to advocate for their rights;
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Birthrights’ communications have improved in a number of areas including increased social media reach and influence which has seen us reach 180% more non-followers a month on Instagram; improvements to the Birthrights newsletter which saw us hit a 55.5% open rate in March 2024 (above the industry average of 40%); as well as improvements to the Birthrights website where we’ve increased the average visitor duration time by 146%;
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We advised policy makers, heads of midwifery and other midwifery leaders, and regulators on growing sector interest in out of guidelines care and unassisted births;
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We submitted evidence to module 3 of the Covid Inquiry, the Sentencing Council, the Birth Trauma APPG and the UN International Rapporteur on Violence Against Women and Girls. In our submissions, we centred how poor culture and practice within the maternity system disproportionately impacts marginalised communities; and
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We continued to improve the health and resilience in the way we work so that we build a strong infrastructure to operate in. This has included implementing a new CRM System and migrating all staff to Microsoft 365.
6.1 Information and Advice
We support women and birthing people to get their voices heard so decisions about their bodies and their care are respected. We do this by equipping them with information about their human rights in maternity care so they can advocate for themselves. We are the only organisation in the UK to provide rights-based information on birth options from maternal request caesarean to unassisted births. And we provide practical advice and more intensive support via our email advice service. In 2023/24 we started offering free advice sessions in community settings, and trialling a telephony service to those for whom the scale of oppression they experience means self-advocacy is not possible. When women and birthing people have information and support to advocate for their rights, birth justice becomes a possibility.
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Report of the trustees
For the year ended 31 March 2024
About the advice service
Our email information and advice service is grounded in a deep understanding of the law and how it relates to maternity care. We combine this with a commitment to provide trauma-informed and empathetic advice and information about rights to women and birthing people, and those supporting them, alongside practical advice on how to raise complaints and self-advocate in discussions with healthcare professionals. Our advice service also receives inquiries from individual maternity professionals who want to find out how to effectively uphold women and birthing people’s reproductive choices and challenge concerning practice and policies in their Trusts using the legal framework.
We continue to see the voices of women and birthing people routinely ignored or dismissed. Trusts and hospitals continue to implement policies and practices that fail to take account of individual need; suspend or restrict access to core maternity services; and do not respect informed decision-making and bodily autonomy.
Within this context, the power of the information and advice Birthrights provides to ensure the experiences and decisions of women and birthing people are heard and supported is clear in the feedback we receive.
‘I’ve honestly felt so empowered, relieved and validated reading the email’
(Feedback from a service user, Nov 2023)
It is crucial that our staff team have both the physical and emotional capacity to respond to increasingly complex and traumatic accounts they receive through the information and advice service. In 2023/24 in response to the changing nature of enquiries coming through to us, we increased capacity within the service to enable the team to respond to and carefully manage complex enquiries, including those about lack of consent, birth trauma and racism to ensure each team member’s emotional wellbeing is safeguarded. We also introduced professional supervision for the information and advice manager and continue to explore ways to broaden our wellbeing support for the whole staff team.
Factsheets
In 2023/24, we had 150,768 unique visitors accessing our factsheets. Whilst we cannot know what proportion of these were pregnant, and what proportion were birthing partners, supporters, wider family members or healthcare professionals, we do know that there were 673,500 births recorded across the UK in 2022. Our factsheets about rights during pregnancy and birth therefore were potentially being accessed in relation to up to 22% of births across the UK.
The top 5 most viewed factsheets (and their unique visitor numbers) were:
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Rights to a caesarean birth (31,500);
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Human Rights in Maternity Care (17,200);
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Choice of place of birth (16,900);
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Unassisted birth (16,600); and
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Right to NHS Services (15,100).
Enquiries in 2023/24
In 2023/24, we received over 750 enquiries to our advice service. We have seen a reduction in basic numbers of enquiries by about 20% since the height of the Covid-19 pandemic when we received many relating to changing Covid-19 regulations, including the rules around wearing a mask, about the right to any birth partner, or the right to decline Covid-19 testing for appointments or requests for information about Covid-19 vaccinations.
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Birthrights
Report of the trustees
For the year ended 31 March 2024
However, the nature of the advice service has changed markedly across the last four years. A significant number of women and birthing people who had given birth during the pandemic, particularly at the height of restrictions, or who have experienced systemic racism or discrimination during their pregnancy, want to make complex and extensive complaints about the poor nature of their maternity care and human rights breaches. Complaints, particularly around consent and birth trauma, and a number of bereavements, made up the highest volume of all enquiries across the year. Very often, these are detailed and complex, requiring dedicated time, and personalised responses across multiple emails. In many cases, women and birthing people, particularly those identified as not speaking English as a first language, as neurodiverse or from other marginalised communities, or those who have suffered a stillbirth or neonatal death, will share their birth trauma story and require information and practical advice on how to set this out as a formal complaint.
We have extended our services to trial telephone conversations to women and birthing people for whom the scale of oppression they experience means self-advocacy is not possible. Using only email will not be sufficient to ensure they can access the legal advice and process information and support required and is a significant additional barrier for them, often because they have suffered a bereavement during birth. Since January 2024, we have provided additional telephony information and practical advice to four people – all of whom were racially minoritised women who had suffered a loss during birth and who are considering a legal claim. We continue to review the need for and potential to expand access to telephony support.
Advice sessions in communities
We recognise that when women and birthing people have information about their rights, they hold increased power. We want to expand access to this information in marginalised and minoritised communities at greatest risk of rights violations, and recognise the importance of working with community organisations to do this. In November 2023, we started offering free, half-day advice sessions to grassroots birth support groups wishing to invite us into trusted spaces for these communities. In 2023/24, we provided four advice sessions in a mix of online and in-person community settings, with 10-20 people attending each community session.
“You can no longer get pregnant and have a baby without educating yourself […] The session this evening was free information from professionals within the industry and some thoughtprovoking ‘never would have thought of that’ type questions from a local doula. I mean does it get better than that?”
(community session attendee, February 2024)
Demand for this offer is increasing, and we have several sessions booked into 2024/25 with an ambition to grow this offer more widely across the UK.
6.2 Training
Birth justice can only be realised if those who design, manage, deliver and regulate maternity services understand how the law applies and why it is critical for the delivery of safe care. This is why we deliver training to frontline healthcare professionals.
About our training service
We provide training to frontline healthcare professionals in NHS trusts and hospitals, regulators, doulas and birth support workers on how the law relates to maternity care. Within training sessions, we continue to prioritise listening to the feedback and experience of those working in maternity services, and recognise the many challenges of their daily working lives.
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For the year ended 31 March 2024
Our training is always provided by two trainers - one with legal and the other clinical experience. We draw on our experienced staff team and a cohort of dedicated associate trainers to deliver training online and in person across the country.
We have focused in 2023/24 on building consistency into the delivery of our training and have developed a robust on-boarding and quality assurance system to support our Associate Trainers. All courses now contain detailed ‘Trainer Notes’ to allow consistency of information between trainers and we regularly observe our Associates and provide feedback on their delivery. We pair new trainers with more experienced trainers to allow them to develop confidence and independence during their initial sessions. We continue to offer our trainers ‘Workshops’ on a variety of topics to aid their continuing development and providing them with updates on core legislation and case law.
Across our training sessions, we collated feedback from 940 delegates. Of these, 98.2% of respondents stated that their ‘knowledge and understanding of how human rights applies to maternity care’ had improved, with 87.9% of respondents stating that attending the session has impacted on how they will carry out their roles going forward. 97.2% of respondents stated that they would recommend Birthrights’ training to others.
Delivery to community birth workers
We offer subsided training to those working outside the NHS as they do not have the same access to funding, but in many instances are the only trusted individual. In 2023/24 we delivered ‘Human Rights in Maternity Care: Helping Others Navigate the System’ for CSOs in Peterborough, Cardiff and online, supporting 44 doulas, birth workers and peer supporters. The sessions are designed for participants to:
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Learn how human rights law supports advocacy for safe and personalised care;
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Understand what informed consent is and what it means for their community; and
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Practice how to use human rights to challenge embedded and harmful practice.
Our standard training provision operates on a cost-recovery basis, meaning we are limited to how many subsidised sessions we provide and restricted to scheduling them when we know there is reduced demand from Trusts, most commonly during winter months.
“Such valuable training for all birth workers. I would love to see this ripple through the maternity system.”
(Subsidised training session for community group, participant)
Delivery to Regulators in 23/24
It is critically important that regulators of maternity services are aware of human rights law, how it applies to maternity care and how it is critical to the delivery of safe care. In 2023/24 we delivered a series of eight training sessions to 117 staff at MSNI (formerly HSIB).
“Thank you for such a great session. Birthrights is so valuable in protecting the human rights of those mothers that may not be able to do this themselves or know how to.”
(Participant of training delivered to regulator MSNI)
Delivery to NHS in 23/24
With increasing demand for our training services, this year we have tried to build resilience into the Training Team, welcoming an additional staff member alongside working with approximately 35 active Associate Trainers, having recruited more Healthcare Professional Trainers in early 2024. This has meant that we have been able to extend our reach, and in 2023/24 Birthrights ran 100 training courses.
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Report of the trustees
For the year ended 31 March 2024
This was an increase of 85.2% (54 courses) on the previous year. Of this figure, 69% were held in local settings and 31% were held online. This marks a trend of a return to face-to-face sessions in comparison to the previous financial year whereby only 40% of sessions were delivered in person. As maternity services continue to recover from the impacts of the Covid-19 pandemic, we expect to see this trend continue, with an increased preference for in-person training. We will continue to review the need for additional Associate Trainers as our demand increased and our geographical reach extends.
In 2023/24 we trained roughly 2,752 professionals working in maternity settings. Those who attended training included doctors, midwives, anaesthetists, paramedics, birth workers and maternity investigators. We continue to offer our core training to healthcare professionals in both a half and fullday format and over the past 12 months have continued to develop and expand an additional bespoke birth worker training, making it more accessible for those working outside the NHS, including doulas.
Our sessions are delivered in a variety of settings, to a broad mix of delegates. We work with organisations to identify who attends training sessions, with some sessions provided to set groups, e.g. student midwives, whilst others are cross-discipline. We have seen an increase in organisations utilising our offer of a 10% discount for multi-disciplinary teams, with four different organisations successfully applying for this. We offer a discount to encourage an organisational-based approach to rights-based care. Over the coming year we will continue to explore ways to encourage whole-organisation buy-in to our cause.
We have also worked on building more deep-rooted relationships with NHS Trusts, focussing on supporting Trusts to embed meaningful cultural and procedural change. One example is Queen Elizabeth Hospital NHS Foundation Trust. Between November 2023 and March 2024, the Trust commissioned eight face-to-face ‘Human Rights and Informed Consent in Maternity Care’ courses with a total of 124 staff members attending. We worked closely with them to understand their needs and complete a post-course feedback report based on quantitative and qualitative data gathered during sessions and as part of the evaluation forms. This allowed us to provide more detailed recommendations for further sessions and how to embed cultural change. We provided a similar report to Bedford, Luton & Milton Keynes Trust and continue to explore ways to support organisations to make lasting, long-term cultural and structural changes.
“This has been one of the best training sessions I have attended in my three years of being qualified. Thank you so much.”
(Feedback from a community midwife who participated in a training session)
Key themes
One of the unique aspects of our training programmes is that they allow us to hear first-hand from those working on the frontline of maternity services, across a broad range of Trusts, providing us with deeper insight into the issues being faced by NHS staff and women and birthing people. This includes lack of knowledge around informed consent, language barriers and difficulties accessing interpreters, suspension of homebirth services and uncertainty around care outside of guidance.
During this period, we have responded to emerging themes arising from our training sessions or queries received from our Advice Team, ensuring that our training is relevant and up to date, whilst also informing our wider campaigning work.
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Report of the trustees
For the year ended 31 March 2024
We ask participants through feedback forms to tell us what they believe needs to change to create a maternity culture in which human rights are always respected. Common responses include increased staffing and funding, expanding the training offer to reach more colleagues at all levels of the NHS including board and commissioning staff and more time to spend with service users to provide high quality individualised care. Hierarchical tensions between midwifery and obstetric colleagues and a culture of fear surrounding litigation and speaking out against poor practice were also highly evident in responses to this question.
In response to an increase in concerns relating to compassion fatigue and vicarious trauma we have provided additional support to our Associate Trainers to tackle these questions as they arise and adapted our training to include content relating to psychological safety in the workplace. Birthrights continues to be an advocate for better working conditions for those working within the maternity system and will continue to champion a system that is safe for all. Across the year we received multiple responses suggesting Birthrights training become mandatory across maternity care providers.
6.3 Policy, Campaigns and Influencing
We know that too often those involved in shaping maternity care do not understand how human rights applies, and that often healthcare professionals are prohibited from delivering the rights-respecting care they want by bullying and toxic work environments, and local policies they feel they must follow.
This is why we work behind the scenes as a critical friend and publicly hold institutions to account, through strategic use of the law and policy and campaigning work.
Public Affairs
In 2023/24 our public affairs work was focused on submitting evidence to key inquiries:
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The Women’s and Equalities Committee published their report into black maternal health in April 2023, and drawing on evidence from Birthrights and others concluded the current Government and NHS measures to address the disparity in maternal deaths are “necessary but insufficient” and that the Government and NHS leadership have “underestimated” the extent to which racism plays a role in perpetuating inequalities. You can read our response to the report here:
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'Government must eliminate racial disparities in maternal deaths' says Women & Equalities Select Committee - Birthrights;
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We were invited to submit evidence to the UK Covid-19 Public Inquiry Module 3 on the impact of the Covid-19 pandemic on healthcare systems, having also previously been invited to submit to Module 2 on political and administrative decision-making during the pandemic. In our module 3 submission in August 2023, we emphasised that the pandemic has brought the already precarious position of human rights in childbirth into sharp focus; set a harmful precedent for breaches of human rights and highlighted the long-term negative impacts on women and birthing people. We directed attention to the restrictions on birth partners, services and procedures and choices around place of birth, while emphasising the racial disparities and regional differences that had a disproportionate impact on marginalised communities;
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Our submission to the Sentencing Council consultation (along with a broad coalition of voices including Level Up and Birth Companions) on a new mitigating factor for pregnancy contributed to a significant widening of the factor;
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We submitted evidence to the Birth Trauma APPG where we centred the consistent failure to listen to voices of women and birthing people and a complete disregard for their fundamental human rights in maternity care. We highlighted that these do not only lead to individual trauma but also to community and societal trauma and distrust in the healthcare system. After the publication of the Birth Trauma Inquiry report, we highlighted the legal inaccuracy in the report which suggests that consent may be disregarded in “emergency situations”; and
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In our submission to the UN International Rapporteur on Violence Against Women and Girls, during her UK visit, we reported that a lack of understanding around how human rights law applies to maternity care is resulting in violence against women and birthing people, disproportionately impacting those from marginalised communities.
Policy change
We are seen as a source of expert knowledge by many healthcare professionals, and in 2023/24 we have seen a particular interest in unassisted births. We shared our expertise behind the scenes to increase understanding and improve policy and outcomes including to:
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a serious case review which related to an unassisted birth;
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a multi-stakeholder working group convened by the Nursing and Midwifery Council on unassisted births; and
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NHS England to push for greater clarity on pathways to fulfil the legal duty to notify relevant authorities following an unassisted birth and shared our expertise with a newly established task and finish group.
You can read our statement on unassisted births here: https://birthrights.org.uk/2024/02/07/birthrights-statement-on-unassisted-birth/ or our factsheet here https://birthrights.org.uk/factsheets/unassisted-birth/.
We have also worked on creating policy change:
- We were reappointed to the NHS Maternity and Neonatal Stakeholder Council and at the first meeting of the reconvened group we focused attention on inequities at a systemic level;
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We were invited to comment on the Equality and Human Rights Commission’s draft briefing on using equality data in maternity care;
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We are part of the project advisory group of “The NoRePF Project- Improving maternal and child health and social inequalities for those with no recourse to public funds and irregular immigration status”; and
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We have been invited to contribute to national and regional work by providing specific information on the legal framework around unassisted birth and on maternity care that is significantly different from guidelines to Surrey Heartlands Partnership, NHS Lothian, NHS Grampian, and NHS England London Region.
Holding institutions to account
We engage directly with trusts and hospitals about policies and practices that are violating or restricting access to the rights of women and birthing people. We do this when self-advocacy is not working or is not possible for women and birthing people and when the breaches of rights appear to be institutional policy or practice.
“This is so great. I'm only 6 weeks away, so it might not change things for me, but hopefully will help others and if I have another child hopefully homebirth will be available then. I really appreciate your support. It's the first time I've felt listened to and supported during my pregnancy so it means so much.”
(Feedback from someone contacting us regarding our letter to their local trust, March 2024.)
In 2023/24 we wrote to 10 trusts and hospitals across the UK about concerning policies and practices. These predominantly related to:
-
Suspensions, restrictions and closures of home birth services;
-
Visitor policies restricting birth partners presence before and after birth; and
-
We are developing a decision framework to guide our next steps following initial letters to push for institutional and systemic change.
Campaigns
In 2023/24, we focused on building our relationships with other organisations and setting the groundwork for campaigns which have launched in 2024/25.
We continue to work in sisterhood with other organisations where there is strong alignment with protecting universal human rights and with reproductive justice, including:
-
As a member of the Save Our HRA Coalition (a coalition of 270 charities and expert organisations working to protect human rights), where we support work to threats posed to human rights frameworks; and
-
Joining calls led by RCOG and BPAS in support of Dame Diana Johnson MP’s amendment to the Criminal Justice Bill which will ensure that vulnerable women in England and Wales will no longer be subject to years-long investigation, criminal charges, and custodial sentences for ending their own pregnancy.
6.4 Extending our reach through communications
In 2023/24 we focused on strengthening our social media, website and supporter newsletter including through building foundational analytic capacity, developing our assets and experimenting with different types of content and look and feel, with a view to extending our reach.
14
Birthrights
Report of the trustees
For the year ended 31 March 2024
Assets
To celebrate our 10th anniversary, we developed a video about our service offer across information, advice and training and the impact this has. It was important to us that we approached this video with the intention to do no harm, focusing on how our services have helped rather than traumatic experiences of those reaching our services. You can watch the video here.
We also commissioned a poem by the incredible poet Desree which was performed at our 10th anniversary event. It was a deeply moving and powerful expression of our collective vision for maternity care and in 2024/25 will be filmed for use on our social media and website.
Social media
From January, we started to create and experiment with new types of social media content such as bringing the Birthrights’ factsheets to life via infographic reels such as this one.
Between Jan-April 2024 we started to see noticeable improvements in the performance of Birthrights social media channels as a result. On Instagram in January 2024, the organisation was reaching around 2,500 non-follower accounts per month but in February this climbed by 99% to almost 5,000 and in April this figure had climbed again to over 7,000.
Our post impressions on X (previously Twitter) also showed some improvement during this time and between Jan-Feb 2024 our post impressions increased by over 115%. On Meta (previously Facebook) there was also a 112% improvement in post reach during the same period.
The biggest growth however was seen on LinkedIn where organic impressions grew from 150 per month in January 2024 to 5,027 in March – an increase of over 3,000%.
Some of our top performing content on social media this year has been:
-
On Instagram, our gestational diabetes infographic reel reached 3,757 accounts (2,017 non followers) and had 4,716 plays with total watch time of 5 hours 40 mins within its first month of posting;
-
On X, our post about co-CEO Janaki Mahadevan's participation in the Labour African Network’s panel discussion “Why are Black women still four times more likely to die in childbirth than their peers?” accrued 1,198 impressions with an engagement rate of 8.2%;
-
On Meta, our International Women's Day post linking to a blog post all about our UN Special Rapporteur on Violence Against Women and Girls evidence submission accrued 4,800 impressions and almost 500 interactions;
-
On LinkedIn our post linking new GP guidance around interpretation and translation services with our ‘Your Basic Birthrights’ translated factsheets accrued 784 impressions and 56 clicks; and
-
In January 2024 there were 238 referrals to the Birthrights website from our social media accounts, but by April this had increased by 53% to 366.
Website
Updating and increasing the performance, readability and engagement of our website is also an ongoing and priority area of work for the communications team to make sure that visitors are not siloed when they visit the site and that we take visitors between different areas of the Birthrights offering.
15
Birthrights
Report of the trustees
For the year ended 31 March 2024
For the 2023-24 financial year, the Birthrights website received 219,000 unique visitors and during this time we have managed to increase the page views per visit by 20%, reduce the bounce rate (the number of people who enter the website and leave after only viewing one page) by 7%, and increase the average visitor duration on the website by 145% to 59 seconds, where previously visitors only stayed on the website for an average of 24 seconds. Our most popular webpages (after the homepage) were our factsheets where visitor duration times varied from just over one minute all the way up to 13 minutes and 55 seconds. The average visitor duration time spent on our factsheets was just over six minutes in total, with visitors spending the longest time on ‘Your Right to NHS Services’ and ‘Social Services and Maternity Care’. Throughout the year our racial injustice inquiry also remained popular with over 6,000 visitors spending an average of just over five minutes on this webpage.
Newsletter
We restarted our newsletter to supporters in Autumn 2023, and at the start of 2024 we gave the Birthrights newsletter a branding/graphics refresh to make the newsletter appear better in people’s inboxes, increase readability and open rate, and improve conversions.
During February-October 2023 our newsletter had an approximate average open rate of 49% and click rate of 5%. By the end of March 2024, this had increased to an open rate of 55.5% and click rate of 6.5% – well above the non-profit sector average of 40% open rate and 3.27% click rate.
Press
Throughout the year, Birthrights has been quoted and/or referenced in a number of different news outlets including the BBC, The Sunday Post, Sky News, Telegraph, Health Service Journal. As well as an op-ed in the New Statesman on black maternal health, and an interview with Shanthi and Janaki in Third Sector about job-sharing.
Articles and their headlines (including online links where applicable) can be found below:
-
BBC – ‘End racial disparities in maternity care’;
-
New Statesman – ‘The scandal of black maternity deaths has to end’;
-
Sunday Post - ‘Home birth suspensions driven by gaps in midwifery workforce’;
-
Sky News - ‘'I've lost control of my birth': Caesarean sections delayed due to NHS strike’;
-
Third Sector – ‘The rise of charity job shares’;
-
Health Service Journal - ‘Exclusive: Rise in ‘free births’ raised with government and regulators’; and
-
Telegraph - ‘No doctor, no midwife – why more women are giving birth alone‘.
6.5 Strengthening our organisation
Over the past year we have worked hard to lay the foundations for the future of Birthrights, ensuring that we have the team and strategy to enable us to be a strong, efficient and resilient organisation in the years to come.
This has meant some hard decisions and deep reflection over 2022 to 2024 regarding our staff capacity, which resulted in a new team structure in 2023/24. This included building resilience in our advice and information and training teams, and a renewed focus on campaigning, communications, fundraising, policy and operations, recognising their critical importance in helping us to reach our core mission as a charity.
16
Birthrights
Report of the trustees
For the year ended 31 March 2024
Alongside this we have also worked extensively to review, plan and create our new strategic framework which will come into effect in 2024/25, but for which much of the deep thinking has been carried out during this period. This sets out a framework for how we aim to achieve our vision of a world where women and birthing people can access safe maternity care that fully respects their right to bodily autonomy and self-agency, free from discrimination, coercion and violence.
At the operational level, we have focussed on strengthening our internal data security and professionalising our IT offer. We migrated to one single provider for our email and document storage system and partnered with a specialist IT company to provide full IT support and security, including premium level anti-virus and ransomware protection, data backup, automatic updates and remote employee device management. This has now resulted in a Best Practice Analysis review of our IT structure as ‘outstanding’ in the key areas of business continuity; physical infrastructure; device security; infrastructure security; user security; and productivity.
We have also worked reflectively towards our ambition of becoming an anti-oppression transformative organisation. We have started a series of extensive whole staff training sessions with thought-leaders JMB on racialisation and white supremacy, deepening our knowledge, challenging our own thinking and working towards dismantling embedded racism within our everyday personal and professional lives. This work will continue into 2024/25. We also undertook LGBTQ+ competency training with the Queer Birth Club to ensure that we are truly an organisation for all women and birthing people.
7. Principal risks and uncertainties
During the year Birthrights have further developed our risk management approach, embedding a framework designed to support the organisation’s leadership to manage, rather than eliminate risk and support informed decision making. The framework supports colleagues to take a consistent approach to identifying and managing risk, ultimately ensuring risk is managed within the Board-agreed appetite and tolerance.
The staff team are essential to the identification, evaluation and management of risks, and we have tried during the year to build wider thinking and planning of risks and mitigations into every layer of our team’s planning. Our approach is currently based on recognising and managing immediate and longterm risks, as well as identifying unexpected issues that have arisen within our operations. We consider all risks against the risk to the organisation, its people and the delivery of our strategic aims, and we plan to further build on this model – an area of work which will be led by our newly appointed Risk, Governance and Performance Operations Lead.
The Finance, Audit and Risk Committee reviews the risk register regularly and Birthrights’ trustees determine how much risk the charity is willing to take in the pursuit of its objectives. The Finance, Audit & Risk Committee reviews the operational effectiveness of the risk management and it reports its findings to the Board, identifying any matters on which it considers action is needed, and making recommendations on the steps to be taken. Our principal strategic risks this year and the mitigations that have been/ are still in place are summarised below.
7.1 Financial Security
The risk: Internal and external financial pressures result in a greater level of financial risk to the organisation. These range from inflationary cost pressures to greater competition and uncertainty in fundraising. A number of our multi-year grant agreements are coming to an end and we no longer have the level of reserves we held previously, meaning the financial risk to the organisation has changed.
17
Birthrights
Report of the trustees
For the year ended 31 March 2024
Our key mitigations:
-
Birthrights has robust processes for budgeting, financial modelling, reporting, and forecasting that support the organisation’s leadership to take informed timely decisions to manage its finances. This has been strengthened further with the appointment of a new accountancy firm to support our financial management and monitoring;
-
Birthrights has established a new Head of Fundraising and Business Development role to lead the organisation’s ambitions to diversify income streams and ensure greater long-term sustainability. Our leadership have also increased our external engagement with new funders, seeking a wider range of partners. Alongside this, we are developing how we measure the impact of our work to further evidence the tangible difference we make; and
-
We have developed a strong ten-year strategy which sets out our ambition and roadmap to achieving real, lasting change in the maternity sector and we now have our full team in place to accelerate the pace of our work and drive forward our strategic goals.
7.2 Board development
The risk: we are anticipating significant change to the make-up of our Board of Trustees into the next financial year, with a number of trustee terms coming to an end or trustees needing to step away from their board commitments for personal reasons. We recognise that there is a risk this transition could impact board effectiveness.
Our key mitigating actions:
-
We have planned recruitment to priority trustee positions and extended our current vice chair’s term by a year to end of December 2024 to ensure continuity of trustees whilst new trustees bed into the organisation;
-
We have Board development plans to support induction of new trustees, review ways of working of the Board and staff team and ensure development of a cohesive and effective Board; and
-
An interim Chair has been identified amongst new trustees to oversee the Board development in the coming months and ensure effective operating of the organisation.
7.3 Staff well-being
The risk: our staff team are our greatest asset, holding so much knowledge and passion to further our strategic ambitions. We recognise that the violations of human rights in maternity care that our team our confronted with every day are deeply traumatising, particularly for so many of our staff team with lived experience of the issues. In addition to this, the wider climate in which we are operating can be deeply de-moralising. There is a risk that our staff experience emotional burn-out.
Our key mitigating actions:
-
A significant driver for our restructure in 23/24 was to increase capacity in our staff team to be able to both respond to the demand on our services and create capacity to better strategically plan how to meet our strategic ambitions to create systemic change;
-
We brought in some supervision for our Advice and Information Manager in 23/24 and are working to bring in supervision for the whole advice team and training team, as well as wider wellbeing support for the whole staff team; and
-
We have started a staff well-being committee and have introduced quarterly in-person team meetings allowing time for collective strategising as well as down-time to simply connect.
18
Birthrights
Report of the trustees
For the year ended 31 March 2024
8. Financial review
8.1 Summary of income and expenditure
In 2023/24 we secured an overall income of £311,737 compared to £423,191 in 2022/23. Restricted income changed from £106,134 in 2022/23 to £50,000 in 2023/24 and unrestricted income (including designated income) changed from £317,057 in 2022/23 to £261,737 in 2023/24. Of this overall unrestricted figure, the CEOs and Treasurer agreed to designate £80,103 of unrestricted funds for specific purposes, such as staff posts and projects. Total expenditure was £486,338 (compared to £382,564 in 2022/23) which was in line with budget expectations.
At the end of 2023, £310,105 of funds were carried forward, of which £89,710 was restricted funds from grants for planned activity in 2023/24 (due to projects being phased across multiple financial years). At the end of March 2024, £135,504 was carried forward into 2024/25, including £32,692 restricted funds, £80,103 designated funds and £22,709 general funds.
8.2 Reserves
At the end of 2023/24, we hold £22,709 in unrestricted reserves. In addition, £80,103 of core funding has been designated by the Trustees but could be reallocated if required.
Our reserves policy states that Birthrights will hold cash reserves to cover three months of operating costs. A three-month reserve would allow Birthrights the opportunity, if necessary, to wind down its programme of support in an orderly and managed fashion, including paying our staff reasonable notice. The Trustees believe this is the appropriate level of reserves to balance prudence and risk management against maximising the benefits the charity can deliver by not tying up too much of our funds in our reserves.
Within the year the trustees took a risk-based approach to our reserves position and enabled Birthrights to briefly operate below the policy threshold in order to maximise on opportunities and strengthen the staff team to provide capacity to build for the future. This analysis considered both the organisation’s and external circumstances, as well as Birthrights’ activities and principal risks.
For 2024/25, three months of operating costs would be £129,642, based on our planned income and expenditure budget.
8.3 Going concern
The trustees consider that the charity will continue as a going concern for a period of at least 12 months from the date on which these financial statements are approved for the following reasons:
-
The charity holds total reserves of £102,812 (including unrestricted and designated funds);
-
The charity is carrying forward a significant unrestricted surplus into 2024/25 which has been designated for core staff costs; and
-
The charity has grants in place which span 2024/25 and beyond.
The trustees therefore consider it appropriate to adopt the going concern basis for the preparation of the accounts, as detailed in note 1(b) to the financial statements. Fundraising will continue to be a major priority for the CEOs and senior team, to ensure sustainability and growth into the future.
19
Birthrights
Report of the trustees
For the year ended 31 March 2024
9. Statement of responsibilities of the trustees
The trustees are responsible for preparing the trustees' report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102: The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).
The law applicable to charities in England and Wales requires the trustees are to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the charity and the incoming resources and application of resources, including the net income or expenditure, of the charity for the year. In preparing those financial statements the trustees are required to:
-
select suitable accounting policies and then apply them consistently;
-
observe the methods and principles in the Charities SORP;
-
make judgements and accounting estimates that are reasonable and prudent;
-
state whether applicable accounting standards and statements of recommended practice have been followed, subject to any material departures disclosed and explained in the financial statements; and
-
prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation.
The trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the charity and which enable them to ensure that the financial statements comply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008 and the provisions of the constitution. The trustees are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charity's website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.
The trustees are members of the charity but this entitles them only to voting rights. The trustees have no beneficial interest in the charity.
10. Independent examiners
Godfrey Wilson Limited were re-appointed as independent examiners to the charity during the year and have expressed their willingness to continue in that capacity.
Approved by the trustees on 8 October 2024 and signed on their behalf by
J A Davis Marcia Lord - Interim Chair John Davis - Treasurer
20
Independent examiner's report
To the trustees of
Birthrights
I report to the trustees on my examination of the accounts of Birthrights (the CIO) for the year ended 31 March 2024, which are set out on pages 22 to 33.
Responsibilities and basis of report
As the charity trustees of the CIO you are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011 (‘the Act’).
I report in respect of my examination of the CIO’s accounts carried out under section 145 of the 2011 Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act.
Independent examiner’s statement
Since the CIO’s gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of the Institute of Chartered Accountants in England and Wales (ICAEW), which is one of the listed bodies.
Godfrey Wilson Limited also provides payroll and bookkeeping services to the CIO. I confirm that as a member of the ICAEW I am subject to the FRC’s Revised Ethical Standard 2016, which I have applied with respect to this engagement.
I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:
-
(1) accounting records were not kept in respect of the CIO as required by section 130 of the Act; or the accounts do not accord with those records; or
-
(3) the accounts do not comply with the applicable requirements concerning the form and content of accounts set out in the Charities (Accounts and Reports) Regulations 2008 other than any requirement that the accounts give a ‘true and fair view' which is not a matter considered as part of an independent examination.
I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.
Date: 8 October 2024 Robert Wilson FCA Member of the ICAEW For and on behalf of: Godfrey Wilson Limited Chartered accountants and statutory auditors 5th Floor Mariner House 62 Prince Street Bristol BS1 4QD
21
Birthrights
Statement of financial activities
For the year ended 31 March 2024
| Note Income from: Donations 3 Charitable activities 4 Investments Total income Expenditure on: Raising funds Charitable activities Total expenditure 5 6 Reconciliation of funds: Total funds brought forward Total funds carried forward Net income / (expenditure) and net movement in funds |
Restricted Unrestricted £ £ 50,000 149,792 - 110,260 - 1,685 50,000 261,737 - 42,620 107,018 336,700 107,018 379,320 (57,018) (117,583) 89,710 220,395 32,692 102,812 |
2024 Total £ 199,792 110,260 1,685 311,737 42,620 443,718 486,338 (174,601) 310,105 135,504 |
2023 Total £ 369,404 53,598 189 |
|---|---|---|---|
| 423,191 | |||
| 52,265 330,299 |
|||
| 382,564 | |||
| 40,627 269,478 |
|||
| 310,105 |
All of the above results are derived from continuing activities. There were no other recognised gains or losses other than those stated above. Movements in funds are disclosed in note 13 to the accounts.
22
Birthrights
Balance sheet
For the year ended 31 March 2024
| Note Current assets Debtors 9 Cash at bank and in hand Liabilities Creditors: amounts falling due within 1 year 10 Net current assets Net assets 12 Funds 13 Restricted funds Unrestricted funds: Designated funds General funds Total charity funds |
£ 99,841 143,479 243,320 (107,816) |
2024 £ 135,504 135,504 32,692 80,103 22,709 135,504 |
2023 £ 73,145 316,148 |
|---|---|---|---|
| 389,293 (79,188) |
|||
| 310,105 | |||
| 310,105 | |||
| 89,710 185,657 34,738 |
|||
| 310,105 |
Approved by the trustees on 8 October 2024 and signed on their behalf by
J A Davis
Marcia Lord - Interim Chair
John Davis - Treasurer
23
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
1. Accounting policies
a) Basis of preparation
The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities in preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102).
Birthrights meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note(s).
b) Going concern basis of accounting
The accounts have been prepared on the assumption that the charity is able to continue as a going concern, which the trustees consider to be appropriate having regard to the current level of unrestricted reserves and future confirmed funding. There are no material uncertainties about the charity's ability to continue as a going concern.
c) Income
Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the item of income have been met, it is probable that the income will be received and the amount can be measured reliably.
Income from the government and other grants, whether 'capital' grants or 'revenue' grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.
Income received under contracts, sponsorship agreements or in advance of provision of training is deferred and recognised when services are delivered.
d) Donated services and facilities
Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item, is probable and the economic benefit can be measured reliably. In accordance with the Charities SORP (FRS 102), general volunteer time is not recognised.
On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.
e) Interest receivable
Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity: this is normally upon notification of the interest paid or payable by the bank.
24
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
1. Accounting policies (continued)
f) Funds accounting
Unrestricted funds are available to spend on activities that further any of the purposes of the charity. Designated funds are unrestricted funds of the charity which the trustees have decided at their discretion to set aside to use for a specific purpose. Restricted funds are donations which the donor has specified are to be solely used for particular areas of the charity's work or for specific projects being undertaken by the charity.
g) Expenditure and irrecoverable VAT
Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably.
Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.
h) Allocation of support and governance costs
Support costs are those functions that assist the work of the charity but do not directly undertake charitable activities. Governance costs are associated with constitutional and statutory requirements. These costs have been allocated between cost of raising funds and expenditure on charitable activities on the basis of staff time:
| 2024 | 2023 | |
|---|---|---|
| Raising funds | 11% | 15% |
| Charitable activities | 89% | 85% |
i) Debtors
Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.
j) Cash at bank and in hand
Cash at bank and cash in hand includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.
k) Creditors
Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.
l) Financial instruments
The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently recognised at amortised cost using the effective interest method.
25
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
1. Accounting policies (continued)
m) Pension costs
The charity operates a defined contribution pension scheme for its employees. There are no further liabilities other than that already recognised in the SOFA.
n) Accounting estimates and key judgements
In the application of the charity's accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.
The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.
There are no sources of estimation uncertainty that have a significant effect on the amounts recognised in the financial statements.
2. Prior period comparatives
| Income from: Donations Charitable activities Investments Total income Expenditure on: Raising funds Charitable activities Total expenditure Net income / (expenditure) and net movement in funds |
Restricted £ £ 106,134 263,270 - 53,598 - 189 106,134 317,057 - 52,265 63,724 266,575 63,724 318,840 42,410 (1,783) Unrestricted |
2023 Total £ 369,404 53,598 189 |
|---|---|---|
| 423,191 | ||
| 52,265 330,299 |
||
| 382,564 | ||
| 40,627 |
26
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
3. Income from donations
| Donations Grants > £5,000 Esmée Fairbairn Foundation Joseph Rowntree Charitable Trust The Owl Trust Gifts in kind Total income from donations Prior year comparative Donations Grants > £5,000 Esmée Fairbairn Foundation John Ellerman Foundation Thirty Percy Foundation Joseph Rowntree Charitable Trust Best Beginnings The National Lottery The Hospital Saturday Fund The Big Give Gifts in kind Total income from donations |
Restricted £ £ - 23,817 - 75,000 50,000 - - 50,000 - 975 50,000 149,792 Restricted £ £ - 41,065 - 97,500 45,000 - - 100,000 59,134 - - 2,000 - 10,000 2,000 - - 10,205 - 2,500 106,134 263,270 Unrestricted Unrestricted |
2024 Total £ 23,817 75,000 50,000 50,000 975 |
|---|---|---|
| 199,792 | ||
| 2023 Total £ 41,065 97,500 45,000 100,000 59,134 2,000 10,000 2,000 10,205 2,500 |
||
| 369,404 |
*Gifts in kind relate to pro bono legal advice, training, stationery, printed materials and room hire.
The charity received government grants, defined as funding from the National Lottery to fund charitable activities. The total value of such grants in the year ending 31 March 2024 was £nil (2023: £10,000). There are no unfulfilled conditions or contingencies attaching to these grants.
27
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
4. Income from charitable activities
| Income from charitable activities | ||
|---|---|---|
| Training, conferences and events Other Total income from charitable activities |
2024 Total £ 110,010 250 110,260 |
2023 Total £ 51,930 1,668 |
| 53,598 |
All income from charitable activities in the current and prior year was unrestricted.
5. Total expenditure
| Staff costs (note 7) Research participation Legal and professional fees Marketing and communications Room hire Accountancy Staff recruitment and training IT equipment and software Travel and subsistence Office costs Insurance Sub-total Total expenditure Allocation of support and governance costs |
£ 31,886 - - - - - - 78 - - - 31,964 10,656 42,620 Raising funds |
£ 267,479 750 50,752 1,567 4,155 - - 12,241 13,809 3,578 - 354,331 89,387 443,718 Charitable activities |
£ 59,506 - - - - 9,333 26,221 - - 3,978 1,005 100,043 (100,043) - Support and governance |
2024 Total £ 358,871 750 50,752 1,567 4,155 9,333 26,221 12,319 13,809 7,556 1,005 |
|---|---|---|---|---|
| 486,338 - |
||||
| 486,338 |
Total governance costs were £2,100 (2023: £1.920). The prior year figure has been restated to more accurately reflect the total governance costs in the year.
28
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
| 5. Total expenditure (continued) Prior year comparative Staff costs (note 7) Research participation Legal and professional fees Marketing and communications Room hire Accountancy Staff recruitment and training IT equipment and software Travel and subsistence Office costs Insurance Sub-total Total expenditure Allocation of support and governance costs |
£ 36,706 - - - - - - 1,342 - 1,015 - 39,063 13,202 52,265 Raising funds |
£ 204,744 578 20,195 2,243 2,000 - - 17,845 7,587 1,471 - 256,663 73,636 330,299 Charitable activities |
£ 55,861 - - - - 8,195 19,615 - - 2,051 1,116 86,838 (86,838) - Support and governance |
2023 Total £ 297,311 578 20,195 2,243 2,000 8,195 19,615 19,187 7,587 4,537 1,116 |
|---|---|---|---|---|
| 382,564 - |
||||
| 382,564 |
6. Net movement in funds
This is stated after charging:
| Trustees' remuneration Trustees' reimbursed expenses Independent examiners' remuneration: Independent examination (including VAT) Other services |
2024 £ Nil Nil 2,100 7,233 |
2023 £ Nil Nil 1,920 6,275 |
|---|---|---|
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Birthrights
Notes to the financial statements
For the year ended 31 March 2024
7. Staff costs and numbers Staff costs were as follows:
| Salaries and wages Social security costs Pension costs Freelancers |
2024 £ 299,342 20,190 6,284 33,055 358,871 |
2023 £ 238,139 14,857 5,111 39,704 |
|---|---|---|
| 297,811 |
No employee earned more than £60,000 during the year.
The key management personnel of the charity comprise the Trustees, Chief Executive Officers and Engagement Director. The total employee benefits of the key management personnel were £117,208 (2023: £127,159).
| Average head count Average full time equivalent |
2024 No. 12 7 |
2023 No. 12 |
|---|---|---|
| 7 |
8. Taxation
The charity is exempt from corporation tax as all its income is charitable and is applied for charitable purposes.
| 9. Debtors Trade debtors Prepayments 10. Creditors: amounts due within 1 year Trade creditors Accruals Deferred income (note 11) Other creditors |
2024 £ 95,965 3,876 99,841 2024 £ 2,989 5,517 99,310 - 107,816 |
2023 £ 73,145 - |
|---|---|---|
| 73,145 | ||
| 2023 £ 761 2,420 70,995 5,012 |
||
| 79,188 |
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Birthrights
Notes to the financial statements
For the year ended 31 March 2024
| the year ended 31 March 2024 | ||
|---|---|---|
| Deferred income At 1 April 2023 Deferred during the year Released during the year At 31 March 2024 |
2024 £ 70,995 99,310 (70,995) 99,310 |
2023 £ 25,000 70,995 (25,000) |
| 70,995 |
11. Deferred income
Deferred income relates to training invoiced in advance to be delivered during 2023/24.
12. Analysis of net assets between funds
| Current assets Current liabilities Net assets at 31 March 2024 Prior year comparative Current assets Current liabilities Net assets at 31 March 2023 |
Restricted funds £ 32,692 - 32,692 Restricted funds £ 89,710 - 89,710 |
£ 80,103 - 80,103 Designated funds £ 185,657 - 185,657 Designated funds |
£ 130,525 (107,816) 22,709 General funds £ 113,926 (79,188) 34,738 General funds |
Total funds £ 243,320 (107,816) |
|---|---|---|---|---|
| 135,504 | ||||
| Total funds £ 389,293 (79,188) |
||||
| 310,105 |
31
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
13. Movements in funds
| Restricted funds John Ellerman Foundation Joseph Rowntree Charitable Trust The Hospital Saturday Fund Total restricted funds Unrestricted funds Designated funds Esmée Fairbairn, 2021 - 2025 Leigh Day Inquiry Thirty Percy Foundation Total designated funds General funds Total unrestricted funds Total funds |
At 1 April 2023 £ 50,479 37,231 2,000 89,710 97,832 - 87,825 185,657 34,738 220,395 310,105 |
Income £ - 50,000 - |
£ (43,257) (61,761) (2,000) (107,018) (91,556) - (43,998) (135,554) (243,766) (379,320) (486,338) Expenditure |
At 31 March 2024 £ 7,222 25,470 - |
|---|---|---|---|---|
| 50,000 | 32,692 | |||
| 25,000 5,000 - |
31,276 5,000 43,827 |
|||
| 30,000 | 80,103 | |||
| 231,737 | 22,709 | |||
| 261,737 | 102,812 | |||
| 311,737 | 135,504 |
Purposes of restricted funds
John Ellerman Foundation
Two year grant for Birthrights to convene a national inquiry into racial injustice in maternity care, towards delivery and staff costs, including a new post to ensure the inquiry is co produced by Black, Brown and mixed ethnicity women and birthing people.
Joseph Rowntree Charitable Trust
Restricted grant towards our work to centre anti-racism in all we do, including through enhanced training with JMB and contribution to staffing costs.
The Hospital Saturday Fund
Grant funding to enable Birthrights to provide advice, training and support so that everyone receives the respect and dignity they deserve in pregnancy and childbirth.
Purpose of designated funds
Esmée Fairbairn Foundation 2021 - 2025
Funding over four years towards unrestricted core costs to protect human rights in maternity care through advice, training and influencing.
32
Birthrights
Notes to the financial statements
For the year ended 31 March 2024
13. Movements in funds (continued)
Leigh Day Inquiry
Unrestricted corporate donation designated for events, communications and consultancy costs.
Thirty Percy Foundation
Three year unrestricted grant designated for staff and operational costs, including a new senior post to lead and develop our communications and engagement work, to reach and support more women and birthing people with a diverse range of needs and experiences.
Prior year comparative
| Restricted funds Baring Foundation, Legal Action John Ellerman Foundation King's College London The Hospital Saturday Fund Total restricted funds Unrestricted funds Designated funds C and P Esmée Fairbairn, 2021 - 2025 Esmée Fairbairn, COVID Leigh Day Inquiry Peabody Safer Beginnings Thirty Percy Foundation Total designated funds General funds Total unrestricted funds Total funds Joseph Rowntree Charitable Trust |
At 1 April 2022 £ 1,695 33,226 11,588 791 - 47,300 14,916 68,635 10,886 7,194 4,313 7,479 37,475 150,898 71,280 222,178 269,478 |
Income £ - 45,000 59,134 - 2,000 |
£ £ (1,695) - (27,747) 50,479 (33,491) 37,231 (791) - - 2,000 (63,724) 89,710 (14,916) - (68,303) 97,832 (10,886) - (15,194) - (4,313) - (9,479) - (49,650) 87,825 (172,741) 185,657 (146,099) 34,738 (318,840) 220,395 (382,564) 310,105 At 31 March 2023 Expenditure |
£ £ (1,695) - (27,747) 50,479 (33,491) 37,231 (791) - - 2,000 (63,724) 89,710 (14,916) - (68,303) 97,832 (10,886) - (15,194) - (4,313) - (9,479) - (49,650) 87,825 (172,741) 185,657 (146,099) 34,738 (318,840) 220,395 (382,564) 310,105 At 31 March 2023 Expenditure |
|---|---|---|---|---|
| 106,134 | 89,710 | |||
| - 97,500 - 8,000 - 2,000 100,000 |
- 97,832 - - - - 87,825 |
|||
| 207,500 | 185,657 | |||
| 109,557 | 34,738 | |||
| 317,057 | 220,395 | |||
| 423,191 | 310,105 |
14. Related party transactions
There were no related party transactions in the current year or prior year.
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